Physiological and Nutritional Determinants of Stunted Odontogenesis: Associations with Parathyroid Hormone, Calcium, and Weaning Practices in a Community-Based Study

Evidence from a Pediatric Cohort Attending Dental and Pediatric Clinics

Abstract

Background: Stunted odontogenesis in children has been linked to disturbances in mineral metabolism, nutrition, and hormonal regulation. Objective: This study investigated the relationship between parathyroid hormone (PTH), serum calcium, and related biochemical parameters with stunted odontogenesis in children, with a special focus on the impact of weaning age. Study Design: Cross-sectional study. Settings: Dental outpatient department (OPD) and pediatric clinics of the Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan. Duration: July 1, 2024, to December 31, 2024. Methods: Among 250 children attending dental outpatient and pediatric clinics. BMI and MUAC assessed nutritional status. Serum calcium, PTH, vitamin D, Magnesium, and other biochemical markers were measured. Participants were grouped by weaning age (6 months, 1 year, and 2 years) to explore differences in biochemical parameters. Results: This study population exhibited a lower-normal mean BMI (17.39 ± 2.89 kg/m²) and MUAC (14.91 ± 3.90 cm). Children weaned at 1 year had higher mean serum calcium (8.58 ± 1.01 mg/dL) and Magnesium (1.81 ± 0.32 mg/dL) compared to those weaned earlier or later. Statistically significant differences were found among the weaning groups for PTH (p = 0.048), Magnesium (p = 0.038), calcitonin (p = 0.001), and folic acid (p = 0.004). A moderate male predominance (60.4%) was noted, reflecting local healthcare utilization patterns. Conclusion: The findings highlight a critical interplay between disturbances in the calcium, vitamin D–PTH axis and stunted odontogenesis. Severe vitamin D deficiency and hypocalcemia likely contribute to the defective mineralization of enamel and dentine. At the same time, the timing of weaning appears to modulate levels of mineral-regulating hormones and micronutrients essential for normal dental development.